BMC Nephrology最新文献

{"title":"Factors associated with resilience among patients with end-stage kidney disease receiving hemodialysis in a teaching hospital: a cross-sectional study.","authors":"Bimala Poudel, Rekha Timalsina","doi":"10.1186/s12882-025-04008-3","DOIUrl":"10.1186/s12882-025-04008-3","url":null,"abstract":"<p><strong>Backgrounds: </strong>Patients with End-Stage Kidney Disease (ESKD) receiving Hemodialysis (HD) face significant psychosocial and physical challenges. Improving their resilience by integrating protective factors is important for effectively managing the difficulties associated with the disease and its treatment. This study intended to identify factors associated with resilience among patients with ESKD receiving HD.</p><p><strong>Methods: </strong>A cross-sectional analytical study was done among 143 patients with ESKD receiving HD in a Tertiary Hospital \"A\" in Nepal. A non-probability convenience sampling technique was used to select samples. Data were collected following ethical approval through face-to-face interviews. A Nepali version of socio-demographic and clinical characteristics-related questions and five standardized and structured instruments were used to measure resilience, family support, illness cognition, self-efficacy, and self-esteem. Data were analyzed with descriptive and inferential statistics (i.e., correlation and multiple linear regression) using the Statistical Package for Social Science Software version 16.</p><p><strong>Results: </strong>The respondents had intermediate (49.0%), low (27.3%), and high (23.7%) levels of resilience. Illness cognition, self-efficacy, and self-esteem had statistically significant positive associations with resilience. However, age was negatively associated with resilience. These associated variables account for 64.0% of the variance in resilience (Adjusted R² = 0.64).</p><p><strong>Conclusions: </strong>The highest proportion of patients with ESKD receiving HD had an intermediate level of resilience. Factors such as illness cognition, self-efficacy, and self-esteem play an important role in enhancing resilience while advancing age appears to diminish it. Therefore, focusing on enhancing illness cognition, self-efficacy, and self-esteem with special care on older patients may be an effective strategy for improving resilience in patients with ESKD receiving HD.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"99"},"PeriodicalIF":2.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and predictors of acute kidney injury among traumatic brain injury patients in Northwest Ethiopia: a cohort study using survival analysis.","authors":"Zelalem Alamrew Anteneh, Semew Kassa Kebede, Abebaw Gedef Azene","doi":"10.1186/s12882-025-04024-3","DOIUrl":"10.1186/s12882-025-04024-3","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a sudden and reversible decrease in kidney function, causing the retention of waste products in the blood and potentially resulting in severe complications or death if not timely managed. Studies on AKI among traumatic brain injury patients in low-income nations like Ethiopia is very critical due to the limited healthcare resources, high burden of trauma-related injuries, and lack of robust data on the incidence and risk factors of AKI in such settings, which hinders effective prevention and treatment strategies tailored to these vulnerable populations Therefore, this study aimed to assess the incidence and predictors of AKI among traumatic brain injury patients.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted among 450 adult patients with traumatic brain injuries admitted to Tibebe-Ghion Specialized Hospital in Ethiopia. Kaplan- Meir curve and Log rank test were used to estimate and compare survival probability of different categories. A multivariable Cox proportional hazards model was used to identify determinants of acute kidney injury (AKI).</p><p><strong>Results: </strong>The incidence of AKI was 10.9%, with a median follow-up period of 42 days. Significant predictors of AKI among traumatic brain injury patients included age (AHR: 1.05, 95% CI: 1.02-1.07), severe head injury (AHR: 1.46, 95% CI: 1.02-2.09), unreactive pupillary response (AHR: 4.82, 95% CI: 1.82-12.72), and hypotension (AHR: 3.45, 95% CI: 1.71-6.96).</p><p><strong>Conclusions: </strong>The study found that AKI occurs in more than one in ten patients with traumatic brain injuries, with significant predictors including older age, severe head injury, unreactive pupillary response, and hypotension. These findings highlight the need for careful monitoring and early intervention for high-risk patients to prevent AKI and improve overall outcomes. Implementing targeted prevention and treatment strategies in settings with limited resources can help mitigate the burden of AKI and enhance patient care in vulnerable populations.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"96"},"PeriodicalIF":2.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal organic anion transporter 1: clinical relevance and the underlying mechanisms in chronic kidney disease.","authors":"Changfang You, Jianchun Guo, Yunhao Xun","doi":"10.1186/s12882-025-03974-y","DOIUrl":"10.1186/s12882-025-03974-y","url":null,"abstract":"<p><p>Organic anion transporter 1 (OAT1), primarily found in the renal proximal tubule, is essential for the excretion of various uremic toxins that contribute to the onset and progression of chronic kidney disease (CKD). OAT1 also plays a vital role in the remote sensing and signaling network, facilitating the removal of metabolites through the kidneys. The function of OAT1 is impaired under conditions such as renal ischemia/reperfusion injury, oxidative stress, and fibrosis. Several transcription factors, post-translational modifications, and endocrine hormones control the activity and expression of OAT1. This review explores the unique contribution of OAT1 to the excretion of CKD-related UTs and the mechanisms involved.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"93"},"PeriodicalIF":2.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of asymptomatic kidney stones on disease progression in autosomal dominant polycystic kidney disease.","authors":"Omer Celal Elcioglu, Beyza Yatci, Burak Baris Ozturk, Safak Mirioglu, Meltem Gursu, Rumeyza Kazancioglu","doi":"10.1186/s12882-025-03979-7","DOIUrl":"10.1186/s12882-025-03979-7","url":null,"abstract":"<p><strong>Background: </strong>Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a common hereditary disorder leading to end-stage kidney disease due to the progressive formation of renal cysts. Nephrolithiasis is a frequent complication of ADPKD, with a prevalence significantly higher than in the general population. However, its role in disease progression remains underexplored. This study investigates the impact of asymptomatic nephrolithiasis on kidney function decline in ADPKD patients.</p><p><strong>Methods: </strong>A retrospective cohort of 195 ADPKD patients was followed at our nephrology clinic. Of these, 85 patients had nephrolithiasis (N+), and 110 did not (N-). Data on demographic characteristics, biochemical parameters, and kidney function were collected. ΔeGFR (change in eGFR over time) served as the primary outcome. Statistical analyses, including correlation and multiple linear regression, were performed to assess the predictors of ΔeGFR.</p><p><strong>Results: </strong>The N + group exhibited a significantly greater decline in kidney function compared to the N- group (ΔeGFR: 16.53 vs. 12.82 mL/min/1.73 m², p = 0.008). Lower calcium levels were observed in the N + group (p = 0.007), potentially reflecting metabolic abnormalities linked to nephrolithiasis. Nephrolithiasis was independently associated with kidney function decline (B = 3.159, p = 0.038). Follow-up duration was strongly associated with ΔeGFR (p < 0.001). Age showed a trend toward significance but did not reach statistical significance.</p><p><strong>Conclusion: </strong>Asymptomatic nephrolithiasis is associated with accelerated kidney function decline in ADPKD patients. These findings highlight the importance of monitoring kidney stones, even in the absence of symptoms, to mitigate their impact on renal dysfunction.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"94"},"PeriodicalIF":2.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, associated factors and clinical implications of subjective cognitive decline linked to frailty in patients receiving maintenance hemodialysis: a cross-sectional study.","authors":"Jie Li, Yue Gao, Xianghong Li, Youhui Yu, Guiyong Li, Huaihong Yuan","doi":"10.1186/s12882-025-04020-7","DOIUrl":"10.1186/s12882-025-04020-7","url":null,"abstract":"<p><strong>Background: </strong>Subjective cognitive decline (SCD) significantly increases a patient's risk of long-term cognitive decline and is common in adults. However, few studies have evaluated patients with end-stage renal disease receiving maintenance hemodialysis (MHD). In addition, the relationship between frailty and SCD in MHD patients remains unclear. Therefore, this study aimed to assess the potential factors affecting SCD in MHD patients and to investigate the relationship between frailty and SCD.</p><p><strong>Methods: </strong>This was a cross-sectional study. From December 2023 to April 2024, via the convenience sampling method, a total of 171 patients from West China Hospital of Sichuan University were recruited to participate in this study. The demographic and sociological characteristics of the participants were assessed via a general information questionnaire. The subjective cognitive decline questionnaire 9 (SCD-Q9), the Tilburg frailty indicator (TFI), the subjective global nutritional assessment (SGA) and the grip dynamometer were used to assess the participants' subjective cognitive level, frailty, nutritional status, and grip strength, respectively. Univariate analyses were used to examine potential factors associated with SCD. Linear regression was used to analyze the relationships between these factors and SCD. Spearman's correlation was used to assess the association between SCD and frailty.</p><p><strong>Results: </strong>The average subjective cognitive decline score of the 171 MHD patients was 4.00 (2.00-7.00), and 95 patients (55.56%) with scores > 3 presented with SCD. Linear regression analysis revealed that sex, work status, grip strength, SGA, and frailty were influential factors in MHD patients, explaining 38.80% of the total variation in SCD. Spearman's analysis revealed that SCD was positively correlated with frailty in MHD patients (r = 0.431, P < 0.001).</p><p><strong>Conclusions: </strong>The prevalence of SCD in MHD patients is common and correlates with certain patient characteristics, including sex, work status, grip strength, SGA, and frailty. Healthcare workers should pay attention to the assessment of subjective cognitive function in this population, remain aware of the risk factors for SCD, and take targeted interventions as early as possible, which can help improve the quality of survival and slow the occurrence of cognitive impairment.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"92"},"PeriodicalIF":2.2,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meprin β regulates osteopontin-signaling in ischemia/reperfusion-induced kidney injury.","authors":"Faihaa Ahmed, Shaymaa Abousaad, Ayman Abouzeid, Christine Adhiambo, Elimelda Moige Ongeri","doi":"10.1186/s12882-025-03995-7","DOIUrl":"10.1186/s12882-025-03995-7","url":null,"abstract":"<p><strong>Background: </strong>Meprin metalloproteases have been implicated in the pathology of ischemia/reperfusion (IR) induced kidney injury. Meprin β proteolytically processes several mediators of cell signaling pathways involved in apoptosis and extracellular matrix metabolism. We previously showed that meprin β cleaves osteopontin (OPN) in vitro. The objective of the current study was to determine how meprin β expression affects OPN and downstream mediators of the OPN-signaling pathway in IR-induced kidney injury.</p><p><strong>Methods: </strong>Ischemia/Reperfusion injury was induced in wild-type (WT) and meprin β knockout (βKO) mice. Blood samples and kidney tissues were obtained at 24 h post-IR. The levels of OPN, Caspase-3, Bcl-2, and NFκB were evaluated using real-time PCR, western blot, and immunohistochemical approaches. Data analysis utilized a combination of 2-way ANOVA and unpaired t test.</p><p><strong>Results: </strong>OPN mRNA increased in both genotypes at 24 h post-IR. Immunohistochemical staining showed IR-associated increases in the levels of OPN in both genotypes. Additionally, we observed higher levels of OPN in the lumen of proximal tubules in WT only, suggesting that meprin β contributes to enhanced release of OPN into filtrate and ultimately into urine. Immunohistochemical staining showed significant increases in the levels of Caspase-3 and NFκB in select tubules of WT only, while Bcl-2 staining intensity increased significantly in both genotypes at 24 h post-IR.</p><p><strong>Conclusions: </strong>These findings suggest that meprin β modulates OPN levels in IR-induced kidney injury and impacts apoptotic genes regulated by the OPN signaling pathway.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"90"},"PeriodicalIF":2.2,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between intradialytic blood pressure variability and cognitive impairment in patients on maintenance hemodialysis.","authors":"Jingfang Wan, Jun Liu, Jing Pan, Lili Fu, Dandan He, Yaru Yao, Yani He, Kehong Chen","doi":"10.1186/s12882-024-03908-0","DOIUrl":"10.1186/s12882-024-03908-0","url":null,"abstract":"<p><strong>Background: </strong>The relationship between intradialytic blood pressure variability (BPV) and mild cognitive impairment (MCI) in maintenance hemodialysis (MHD) patients is currently unclear. Our present study aimed to illustrate the correlation between intra-dialysis BPV and CI in MHD patients.</p><p><strong>Methods: </strong>Intradialytic SBP within 3 months before cognitive assessment of the patients were collected as baseline data and averaged as final data. The intradialytic SBP was converted to the following 4 candidate short-term BPV indices: standard deviation (SD), coefficient of variation (CV), average real variability (ARV), RANGE. Overall cognitive function was assessed by the Montreal Cognitive Assessment (MoCA) scale.</p><p><strong>Results: </strong>The study finally enrolled 170 patients with 6662 dialysis records and 26,580 SBP measurements. The mean age of the patients was 57.99 years, the MCI prevalence was 78.24%. Intradialytic SBP ARV (average real variability) was notably higher in patients with MCI than in the non-MCI (NMCI) group (8.91 vs. 7.60, P = 0.042), but there was no statistical difference in the mean SBP and other BPV indices between the two groups. There was a non-linear relationship between SBP ARV and MCI, and the inflection point of SBP ARV was 7.52.</p><p><strong>Conclusion: </strong>Our study found that high SBP ARV was closely associated with MCI, indicating that high SBP ARV may act as an indicator of MCI in MHD patients.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"91"},"PeriodicalIF":2.2,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid intima-media thickness, fibroblast growth factor 23, and mineral bone disorder in children with chronic kidney disease. Knowing the limitations of the applied methodology for a better understanding of the clinical results.","authors":"Christian Saleh","doi":"10.1186/s12882-025-04017-2","DOIUrl":"10.1186/s12882-025-04017-2","url":null,"abstract":"","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"89"},"PeriodicalIF":2.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health professional experiences of kidney transplantation in regional, rural, and remote Australia.","authors":"Tara K Watters, Beverley D Glass, Nicole J Scholes-Robertson, Andrew J Mallett","doi":"10.1186/s12882-025-04015-4","DOIUrl":"10.1186/s12882-025-04015-4","url":null,"abstract":"<p><strong>Background: </strong>Despite the demonstrated improved patient survival and financial benefits for health services with kidney transplantation compared to dialysis, populations outside of urban areas face inequities in access and a more difficult journey to kidney transplantation than their metropolitan counterparts. This study aimed to explore the experiences of Australian kidney transplant health professionals regarding kidney transplantation processes for patients residing in regional, rural, and remote areas, with a focus on improving access to and experiences of transplantation for this patient cohort.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with Australian kidney transplant health professionals. Transcripts were analysed thematically.</p><p><strong>Results: </strong>Interview participants (n = 26) consisted primarily of nephrologists from transplanting centres (15%), nephrologists from regional, rural, or remote non-transplanting centres (19%), clinical pharmacists (19%), and nursing staff (19%). Six main themes were identified regarding barriers to transplantation, including ineffective communication and education, overwhelming geographical burden, fighting for equal opportunities, paucity of social support, crushing financial peril, and deprived of adequate local care. Participants also made recommendations for new or modified service delivery models to address identified barriers, including coordination of work-up testing, outreach visits for transplant assessment, increased social and financial support, and increased and earlier provision of transplant education.</p><p><strong>Conclusions: </strong>Health professionals described patient-specific and system level barriers to kidney transplantation for regional, rural, and remote populations in Australia that could be addressed or improved by the modification of current processes or implementation of new service delivery models for provision of transplant care.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"88"},"PeriodicalIF":2.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indications and complications associated with centrifuge-based therapeutic plasma exchange - a retrospective review.","authors":"David Warner, Heather Duncan, Prakash Gudsoorkar, Manish Anand","doi":"10.1186/s12882-025-03970-2","DOIUrl":"10.1186/s12882-025-03970-2","url":null,"abstract":"<p><strong>Background: </strong>Therapeutic Plasma Exchange (TPE) is an extracorporeal treatment modality used to manage certain conditions caused by plasma deficiencies, autoantibodies, alloantibodies, toxins, and immune complexes. We describe our experience of using TPE for various disease indications and associated complications.</p><p><strong>Methods: </strong>This is a retrospective, single-center review of centrifuge-based TPE performed by the division of nephrology at a tertiary care academic center between July 2018 to June 2022. 1219 TPE treatments in 145 patients were included.</p><p><strong>Results: </strong>The most common indications for TPE were Antibody-Mediated Rejection (AMR) of a kidney transplant (20%), autoimmune encephalitis (16%), and neuromyelitis optica (11%). Rare indications for TPE included Chronic Relapsing Inflammatory Optic Neuropathy (CRION), AMR of a pancreas transplant, osmotic demyelination, and belatacept removal in the setting of COVID-19. The most common complications were depletion coagulopathy (47.6%), hypocalcemia (44.1%), and hypokalemia (36.6%). Rare complications included stiff person crisis and pseudohypertriglyceridemia. 31.7% of patients received TPE for conditions managed by nephrologists.</p><p><strong>Conclusion: </strong>TPE is an extracorporeal treatment modality for managing various renal and non-renal diseases. The study demonstrated that 18.7% of the patients at our center received TPE for conditions in which its role is not yet established, suggesting the need for further research on the use of TPE. In addition, this study supports the necessity of nephrology training program to include education on TPE as almost one-third of the indications for TPE in our center were for conditions managed by nephrologists.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"87"},"PeriodicalIF":2.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}